| Living And Balance Wellness Center | |
|
10000 N 31st Ave Ste C218 Phoenix AZ 85051-9620 | |
| (602) 314-6312 | |
| (602) 926-8317 |
| Full Name | Living And Balance Wellness Center |
|---|---|
| Speciality | Counselor |
| Location | 10000 N 31st Ave Ste C218, Phoenix, Arizona |
| Authorized Official Name and Position | Marie Davis (CEO) |
| Authorized Official Contact | 6023146312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living And Balance Wellness Center 10000 N 31st Ave Ste C218 Phoenix AZ 85051-9620 Ph: (602) 314-6312 | Living And Balance Wellness Center 10000 N 31st Ave Ste C218 Phoenix AZ 85051-9620 Ph: (602) 314-6312 |
| NPI Number | 1255907903 |
|---|---|
| Provider Enumeration Date | 06/02/2021 |
| Last Update Date | 07/31/2024 |
| Certification Date | 07/31/2024 |
| Medicare PECOS PAC ID | 3274923206 |
|---|---|
| Medicare Enrollment ID | O20211207001746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255907903 | NPI | - | NPPES |
| Provider Name | Emetu Onuma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003424771 PECOS PAC ID: 7012397821 Enrollment ID: I20220711000084 |
| Provider Name | Idorenyin Philip |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639886583 PECOS PAC ID: 6800268236 Enrollment ID: I20230329000831 |
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